1887
Volume 2008, Issue 2
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

A prospective! descriptive! non-comparative pilot study was used to evaluate the efficacy of intravitreal injection of triamcinolone acetonide (TA) for the treatment of patients with refractory diabetic macular edema that had not responded to laser treatment. Forty eyes of 35 patients with visual acuity (VA) < 6/12 were infected with TA 4 mgl 0.1 cc under topical anesthesia. Results were assessed and analyzed using changes in visual acuity (VA), retinal thickness (RT) and macular volume measured by optical coherence tomography (OCT). In 62.85 % of cases the VA improved by more than two Snellen's lines, the initial VA (mean! log MAR) being 0.67 changing to 0.31 after six months (p = 0.008). RT improved in all patients, having the most remarkable improvement in the Macular Volume, with a decrease of 2.7 mm3 at the end of the study (p = 0.009). Both improvement ofVA and RT were more marked during the early follow-up. The most common complication was ocular hypertension (OHT) in 22.5 % of eyes, all of which responded to medical antiglaucoma treatment. Intravitreal injection ofTA looks to be a useful option for the treatment of refractory diabetic macular edema.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2008.2.12
2008-12-01
2024-04-19
Loading full text...

Full text loading...

References

  1. Klein R, Klein E, Moss SE. The Wisconsin Epidemiologic Study of Diabetic Retinopathy, IV: diabetic macular edema. Ophthalmology. 1984; 91::14641474.
    [Google Scholar]
  2. Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol. 1985; 103::17961806.
    [Google Scholar]
  3. Lee CM, Oik RJ. Modified grid laser photocoagulation for diffuse diabetic macular edema. Long term visual results. Ophthalmology. 1991; 98::15941602.
    [Google Scholar]
  4. Antcliff RJ, Spalton DJ, Stanford MR. Intravitreal Triamcinolone Acetonide for uveitic cystoid macular edema: An optical coherence tomography study. Ophthalmology. 2001; 108::765772.
    [Google Scholar]
  5. Nauck M, Roth M, Tamm M. Induction of vascular endothelial growth factor by platelet-activating factor and platelet-derived growth factor is downregulated by corticosteroids. Am J Respir Cell Mol Biol. 1997; 16::398406.
    [Google Scholar]
  6. Antonetti DA, Barber AJ, Hollinget LA. Vascular endothelial growth factor induces rapid phosphorylation of tight junctions proteins occludin and zonula occluden 1. J Biol Chem. 1999; 274::2346323467.
    [Google Scholar]
  7. Bresnich GH. Diabetic maculopathy: A critical review highlighting diffuse macular edema. Ophthalmol. 1983; 90::13011307.
    [Google Scholar]
  8. Bresnick GH. Diabetic macular edema: A review. Ophthalmol. 1986; 93::989997.
    [Google Scholar]
  9. Gillies MC, Su T, Stayt J. Effect of high glucose on permeability of retinal capillary endothelium. Invest Ophthalmol Vis Sci. 1997; 38::635641.
    [Google Scholar]
  10. Gardner TW, Lieth E, Khin SA. Astrocytes increases barrier properties and ZO-1 expression in retinal vascular endothelial cells. Invest Ophthalmol Vis Sci. 1997; 38::24232427.
    [Google Scholar]
  11. Wallow IHL, Engerman RL. Permeability and patency of retinal blood vessels in experimental diabetes. Invest Ophthalmol Vis Sci. 1977; 16::447460.
    [Google Scholar]
  12. Vinores SA, Niel EV, Swerdorff JL. Electron microscopic immunocytochemical evidence for the mechanism of blood-retinal barrier breakdown in galactosemic rats. Exp Eye Res. 1993; 57::723735.
    [Google Scholar]
  13. Ashton N. Studies of the retinal capillaries in relation to diabetic and other retinopathies. Br J Ophthlamol. 1963; 47::521538.
    [Google Scholar]
  14. Cogan DG, Toussaint D, Kubawara T. Retinal vascular patterns. Arch Ophthalmol. 1961; 66::100112.
    [Google Scholar]
  15. Krupin T, Waltman SR, Szewczyck P. Fluorometric studies on the blood-retinal barrier in experimental animals. Arch Ophthalmol. 1982; 100::631634.
    [Google Scholar]
  16. Wilson CA, Berkowitz BA, Sato Y. Treatment with intravitreal steroids reduces blood-retinal barrier breakdown due to retinal photocoagulation. Arch Ophthalmol. 1992; 110::11551159.
    [Google Scholar]
  17. Jonas JB, Sofker A. Intraocular injection of crystalline cortisone as adjunctive treatment of diabetic macular edema. Am J Ophthlamol. 2001; 132::425427.
    [Google Scholar]
  18. Martidis A, Duekr JS, Greenberg PB. Intravitreal Triamcinolone for refractory diabetic macular edema. Ophthlamology. 2002; 109::920927.
    [Google Scholar]
  19. Jonas JB, Kreissig I, Sofker A. Intravitreal injection of triamcinolone for diffuse diabetic macular edema. Arch Ophthlamol. 2003; 121::5761.
    [Google Scholar]
  20. Chieh JJ, Roth DB, Liu M. Intravitreal triamcinolone acetonide for diabetic macular edema. Retina. 2005; 25::828834.
    [Google Scholar]
  21. Jonas JB, Kreissig I, Degenring R. Intraocular pressure after intravitreal injection of triamcinolone acetonide. Br J Ophthalmol. 2003; 87::2427.
    [Google Scholar]
  22. Roth DB, Chieh JJ, Spirn MJ. Non-infectiuos endohthalmitis associated with intravitreal triamcinolone injection. Arch Ophthlamol. 2003; 121::12791282.
    [Google Scholar]
  23. Jonas JB, Hayer JR, Panda-Jonas S. Intravitreal injection of crystalline cortisone as adjunctive treatment of proliferative vitreo-retinopathy. Br J of Ophthalmol. 2000; 84::10641067.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/qmj.2008.2.12
Loading
  • Article Type: Research Article
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error